The U.S. has coped with Covid-19 far worse than any other country on the globe. Though much, much of this catastrophe of over 170,000 dead can be laid at Trump’s door, some of it has to do with the uniquely awful American system of for-profit health care. Those words, “for profit,” mean that the U.S. public health infrastructure, always stunted, had completely shriveled by the time the plague struck. Other countries dealt better with covid because they have different health care systems – single payer or Medicare for All systems, in other words, ones that are, to varying degrees, socialized.
Bernie Sanders campaigned on Medicare for All. If he hadn’t been knocked out of the race in South Carolina by the actions of Representative James Clyburn, just as the pandemic struck and killed the economy, causing tens of millions to lose employer-sponsored health insurance just when they became sick, we would have a decent shot in November at finally wrestling this pestilence under control. Because that can only be done with a different health care model, like Medicare for All. Rep. Clyburn thus has the singular distinction and the unique spot in history of having made that impossible. Which means we have no hope of beating covid.
If Trump wins, there will be more bluster about getting rid of Obamacare and replacing it with the imaginary “best health care system ever.” In short, nothing will happen. If Joe “I’d veto Medicare for All” Biden wins…well, he’s already told us what he’d do and it speaks for itself. So both candidates guarantee more status quo, more covid, more overwhelmed hospitals, more dead Americans. From the virus’ perspective, it makes little difference whether Trump or Biden wins. Either way, covid has a free-for-all. The only thing that could have stopped it was Sanders’ Medicare for All, now consigned, fortuitously as far as for-profit health care moguls are concerned, to the dustbin of history.
There are some qualified judgments to make regarding Biden and Trump. Biden will doubtless install better, more professional staff to deal with the pandemic and will listen to scientists and doctors. He will not dismiss the tragedy of covid as a hoax, nor lie and say it will disappear. One assumes Biden will promote vigorous testing and contact tracing. He has already sensibly called for a nationwide mask mandate, causing Trump to retreat at this refreshing display of leadership into defensive platitudes about not playing politics with the disease. But without tackling the whole, demented medical system, there is little hope that Biden can stop this monster.
In Trump’s favor, the only thing one can say is that early on he quietly issued a directive for the covid care tab to be picked up by the government, when individual Americans could not pay. This move received little press attention at the time and none since. So whether the government has followed through on this – and Trump clearly did not wish to advertise such an unorthodox gesture, one conservatives might well find offensive – is unclear. But any politician with a brain would hurry down this path. We need more government aid for covid patients, lots more. Just as we need the National Defense Authorization Act to swing into action to produce the protective gear medical workers need. Just as we need robust testing, so we can isolate the infected and prepare our hospitals for a crush of patients and prepare other medical defenses. Just as we need a national plan to deal with the pandemic. Just as we need finally to eliminate the “for profit” from medicine.
One person who argues very convincingly that the U.S. failure to contain covid derives from its uniquely dreadful and unequal health care system is historian Thomas Frank. His recent Le Monde Diplomatique article was titled “It’s the health care system, stupid.” He critiques those who blame feckless Americans for the virus spinning out of control; after all, had Trump not stupidly elevated mask-wearing to the deadly status of a culture war, and had instead promoted it, millions in his base would have followed his lead.
Instead of the “irresponsible Americans” line, Frank explains that “plenty of blame must go to our screwed-up health care system which scorns the very idea of public health and treats access to medical care as a private luxury that is rightfully available only to some.” The medical community has “for almost a century used the prestige of expertise” to keep health care a privilege of the affluent few, Frank writes. It is doubtful that Frank would regard Biden’s paltry concession – lowering the Medicare eligibility age to 60 – as a solution to our atrocious medical system. But a public option, which provides publicly financed health care and which Biden is considering, is a step in the right direction.
The horrible irony is that the one candidate, Sanders, who could have done the most good for pandemic victims, lost the race just when he was most needed. Since then his somewhat muted support for Medicare for All and how uniquely helpful it would be at this historic juncture, is dispiriting. The thought that this relative silence originates in a desire not to offend the candidate, Biden, whom he now supports, is downright depressing.
Now would be an excellent time to hear full-throated pronouncements from politicians like Sanders – who was so prescient about our ghastly health care system – about the success of, say, Canadian health care. Canada has single payer. It has worked. Our neighbor to the north is not drowning in a sea of covid corpses. It’s time for a little humility here in the U.S. Our health care system is broken. It doesn’t work. We should look elsewhere in the world for a new model. And we should do it fast.